An undescended testicle is one of the most common genital abnormalities in boys, with about 4 percent of the population born with the condition.
Also known as cryptorchidism, undescended testicle occurs when one or both testicles have not dropped down into the scrotum after birth. Boys that are born premature (about 30%) have a higher chance of being born with an undescended testicle. Typically, the testicle will descend during the first year. If not, then surgery is usually performed. The condition is usually classified by the location in the abdomen and whether or not it can be felt during the examination.
Abdominal – The testicle remains in the abdomen and cannot be felt.
Inguinal – The testicle has stopped in the inguinal canal and cannot be felt.
Prescrotal or prepubic – The testicle has stopped further down in the inguinal canal but has not moved into the scrotum. It can be felt during an exam.
As the male fetus develops in the womb, testicles are formed in the abdomen of the body, moving into the scrotum through the inguinal canal before birth. When a testicle is noticed missing during an examination, there are a few possible causes. One cause is that the testicle never formed. In some cases, a blockage in the blood vessels may have caused it to wither. For most boys though, the cause is that it did not descend correctly, remaining in the abdomen.
For some boys, the testicle can be “retractile,” where one or both retract back into the abdomen or slide back in the scrotum, moving back forth occasionally. When this event occurs, the testicle can often be pulled down during an examination. In these cases, the testicles usually entirely descend during puberty.
Management of an Undescended Testicle
For 50 to 75 percent of cases, the undescended testicle will generally descend into the scrotum on its own during the boy’s first year. If this does not occur before the first birthday, a procedure to move one or both of the testicles down will help to prevent complications.
If left untreated for too long, an undescended testicle could cause complication such as fertility issues and sperm production problems. This is because the scrotum adjusts to temperature to keep the testicles at an optimum temperature for sperm production. The body is much too warm for proper production. In addition, when the testicle is inside the abdomen it is at risk for becoming twisted or injured.
Boys born with an undescended testicle are also at a higher risk of developing testicular cancer, making it important to have the testicle in the scrotum for a physical examination to monitor for malignant growth.
Treatment for undescended testicle includes surgery called orchiopexy. During this procedure, a small incision is made in the groin, which will allow the testicle to be moved into the scrotum where it will be “pexed” into place. Another treatment uses an injection of hCG, a hormone, to make the testicle drop.